This month TechNation asked experts about patient monitors to find out the latest advances in these important medical devices. Our panel of experts also shared information on servicing patient monitors and what to look for when purchasing these devices.The panel is made up of Steve Bebb, senior global director, product marketing, patient monitoring, Philips Healthcare; Andy Bonin, president and CEO of Pacific Medical; Stan Grzesiak, BMET, regional director at Medical Electronics; Michele Shahbandeh, owner of Integrity Biomedical Services; Stephen Davis and Shawn Nguyen, lead biomed technicians with USOC Medical; and Steve Ziegenhagen, president of Gopher Medical.
Bebb: Purchasers should look for established suppliers who have a proven track record as a supplier of high-quality, reliable equipment.
Bonin: Biomed professionals need to be forward thinking and plan out 3-5 years for long-term patient monitoring solutions. Planning for equipment while meeting long-term needs should also fit within the future technology of the hospital. The clinical engineering departments must be set up with mission-critical technical training that is consistent across the hospital for investments in-patient monitoring. This training should also include equipment training and detailed literature on parts and services offered by the manufacturer or vendor.
Davis: The purchaser should research exactly what they will be using the monitor for to ensure they are paying for exactly what they need. Such as options, ease of use for the nurses/doctors, if training on the monitors is included, and if a warranty is given.
Grzesiak: If I didn’t know about patient monitors and was asked to make this type of purchase, I would check with different manufacturers and check their record. How long have they been in business? What facilities are using their products?
Nguyen: Whether it’s bedside monitors or portables, patient monitors come in different varieties to suit the requirements of any hospital and small clinics. They allow continuous monitoring of a patient and health care professionals are informed of changes in the general condition of a patient. I believe these vital sign monitors have a good return on investment when it comes to quality health care and is sustainable to the degree that current and future patients can be treated adequately.
Ziegenhagen: By researching the equipment manufactures and using online tools and websites that will allow them to access evidence-based information to enable more educated decisions on medical equipment, unbiased insight into the proper technology at the best price for their hospital, and strategic guidance to help their hospital cut costs of care and, in the end, improve the quality of outcomes. Hospitals need to consider the upfront cost of interfacing to their existing network, clinician notification and communication systems. Some equipment manufacturers offer a 5-year warranty to get attention of the senior management and biomedical engineering departments. Also, consider asking for long warranty periods.
Bebb: When it comes to patient monitors, it’s important to look at full flexibility, both in terms of the ability to scale functionality up or down as appropriate, a simple and common user interface across the entire portfolio as well as the ability to integrate seamlessly into the hospital’s IT infrastructure.
Bonin: Standardization and compatibility to IT’s existing network. Looking at the product life cycle is important. OEM support and third-party support should be taken into consideration and also parts availability and software updates. We also see the importance of monitors built with innovative technology including advanced wireless integration and communication, networking capability and increased storage capability to full system integration. Integration is important so that monitors are also readily upgraded with advances in technology. The demand for all monitors to talk and interact with one another in line with the other systems is very important. Full systems integration helps reporting to central locations and existing systems as well. All patient monitoring solutions should come with the streamlined capability of tying into a hospital’s IT system and remote patient monitoring outside the clinical environment to minimize costs and shorten hospital stays.
Davis: This really depends on the needs of the department, such as ambulatory, surgery, E.R., etc. The purchaser should discuss this with the head of the department to ensure that they are purchasing exactly what they will need.
Nguyen: Medical staff have traditionally relied on five vital signs to access their patients: temperature, pulse, blood pressure, respiratory rate and oxygen saturation. These common features are important when it comes to patient monitoring. Portability and good battery life are a plus, too.
Grzesiak: Match the exact parameters desired with how it’s going to be used. Look at space limitations. Check parts and service availability.
Shahbandeh: Simplicity of use. Have a system that is capable of combining the latest with the earliest models.
Ziegenhagen: The most important features to look for are wireless communication, hardwire infrastructure and bed-to-bed communications. Many equipment manufacturers are offering these multiple features and health care providers need to consider the long-term impact on their infrastructure. The ease of integrating to the hospital’s existing EMR/EHR system, network and nurse call systems need to be considered. Monitor modularity – upgrade ability (onsite or factory) making sure that when it comes to upgrades, the manufacturer offers upgrades to existing equipment.
Bebb: HTM departments should contact other organizations to share experiences using equipment from different manufacturers. Before making a decision, HTM departments should make sure that the supplier provides ongoing and timely support in the event of an issue.
Bonin: Integration is important for the HTM departments when looking for patient monitors. All patient monitoring systems should be evaluated with the current system technology to make sure they are easily integrated across the hospital. HTM managers must make sure that their input and specifications are heard in the beginning and that they roll into the final equipment decisions. Fitting seamlessly into expanded, real-time integrated options, coupled with a wealth of clinically relevant information from the hospital’s intranet and applications is also important. Finding a repair vendor that offers quality refurbished equipment coupled with ISO certifications and OEM-trained personnel is a bonus as well.
Davis/Nguyen: If purchasing equipment from a third party, the purchaser must make sure that the vendor is certified in the OEM products (Philips, GE, Spacelabs, etc.) Provide as much information to the sales rep as possible and, if possible, speak with a technician at the facility and work with them to help ensure that you get exactly the right product for them.
Grzesiak: The best monitors for any facility can be obtained when the budget for such a purchase is established, and a bit of research is completed.
Shahbandeh: Demonstrations by top manufacturers are always a great way to see what they offer.
Ziegenhagen: I would recommend health care facilities consider forming an equipment committee including, but not limited to, purchasing, clinical department users, biomed, IT and senior management. By doing this, it will help drive the equipment selection process more efficiently by having everyone’s input. Plan on-site demonstrations, evaluations and site visits – by working with the equipment manufactures and/or dealers, scheduling demonstrations/evaluations and even site visits for the equipment selection committee team will assure they are making the right decision.
Bebb: While initial purchase price is clearly important, many suppliers can offer attractive financing programs or other mechanisms to optimize the overall longer-term cost of ownership. It’s important to consider the ability and track record of the supplier to allow the system to be kept up to date over time.
Bonin: With the economic budget visibility, more and more hospitals are looking into used/refurbished equipment. HTM’s role also now turns to investing more in research of options for refurbished newer technologies so they can maximize on low cost, and quality equipment from a trusted vendor. Biomed departments should look for a trusted and established vendor who specializes in patient monitor equipment. It is also important to find a vendor that has a large industry selection of parts and inventory availability for after the sale or after sale support service.
Davis/Nguyen: The best way for a facility with a limited budget to still meet its patient monitoring needs would be to purchase used/refurbished equipment with a good warranty from a reputable third-party vendor with certified technicians that also offer technical support, installation and training, if necessary.
Grzesiak: A facility with a limited budget must be creative when making patient monitor purchases. There are several reputable vendors that sell refurbished equipment. Again, research is necessary … and strongly advised!
Shahbandeh: Purchase from a reliable company that offers cost savings and warranties when dealing with refurbished/preowned equipment. Look for an ISO-certified company, accountability and quality.
Ziegenhagen: Consider purchasing refurbished equipment from a reputable company that specializes in patient monitoring equipment that will back your equipment purchase with a warranty and technical support.
Bebb: HTM departments should contact other organizations to learn about their experiences. A high-quality supplier will ensure that this topic is discussed extensively and fine tuned to individual requirements during the pre-sale process.
Bonin: Planning for equipment training at the time of purchase must be established and include a training plan with detailed materials/literature. This training should be scheduled and also include parts and services overviews done by the manufacturer. A technical training plan should be part of the deal upfront and include a focused metric of measurement that is consistent across the hospital.
Davis/Nguyen: Most literature for patient monitors is available online as a PDF. As far as receiving proper training on a new patient monitor, I would look at the vendor that they are purchasing the monitors from and make sure that they offer proper training on all of the items that they sell. Also they should make sure that the training they offer is given by certified technicians.
Grzesiak: Proper training and literature must be negotiated prior to any equipment purchase. The web can be a good source for some literature as well.
Shahbandeh: Company’s like ours can schedule in-service on the equipment.
Ziegenhagen: By working with purchasing/material management to make sure the sales contract or agreement includes the proper training and literature (on-site or off site) at the expense of the equipment provider, operators and service manuals (paper and electronic versions) are recommended.
Bebb: Given the huge investments that hospitals today are making in state-of-the-art IT infrastructure, it’s essential to look for companies that can demonstrate their ability to fully integrate and support their systems within this infrastructure. This includes interoperability with equipment from other manufacturers, as well as seamless integration with the EMR.
Bonin: Compatibility and standardization make for a more efficient hospital.
Davis/Nguyen: There is a large variety of patient monitors and brands today that give the end user a lot of options to look at. Like anything else, I would say that it is important for the purchaser to do their research and talk to the doctors and nurses and talk to the vendor that they are using to make sure they are purchasing the proper monitor
and manufacturer that will overall fit their needs in the hospital.
Grzesiak: Find out what the facility needs first. Check a manufacturer’s history or website. Check with other local facilities’ biomedical engineering departments. Don’t always buy the cheapest product, you and your facility may regret it.
Shahbandeh: Make sure they have a company who offers quality, cost and great customer service. Once the monitor goes out of warranty, you want to have a qualified technician and company performing the repairs.
Ziegenhagen: Training – by making sure they receive the appropriate training by the manufacture and or dealer. If buying refurbished, do your research about the company to make an informed and educated decision. v
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